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Vermont rates for HCPCS L5987

All lower extremity prostheses, shank foot system with vertical loading pylon

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,715.35 / $4,677.35 / $5,370.32
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6,918.31 / $6,918.31 / $6,918.31
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6,025.60 / $6,025.60 / $6,165.95
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,365.16 / $4,365.16 / $6,025.60
MVP Health Care
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6,606.93 / $8,317.64 / $10,232.93
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,265.80 / $5,128.61 / $6,165.95
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,951.21 / $6,309.57 / $17,782.79